Avoid Use of diphenhydramine in special situations-such as for treating severe allergic reactions-may be appropriate.

Antiparkinsonian drugs prescribed for Parkinson's disease and other health problems:

Benztropine (oral)

Trihexyphenidyl

There are other medications that are usually more effective for Parkinson's disease and related disorders than these. The drugs should not be used for other conditions, like treating side effects of other medications (for example the movement side effects of antipsychotic medications).

Avoid

Antispasmodic medications prescribed trelieve cramps or spasms:

Belladonna alkaloids

Clidinium-chlordiazepoxide

Dicyclomine

Hyoscyamine

Propantheline

Scopolamine

It's is not clear whether these drugs are effective, but they have side effects.

Avoid except if used in short-term "comfort care."

Antithrombotics-these are medications tprevent or dissolve blood clots that can form inside blood vessels. These blood clots can be life-threatening.

The short-acting form of Dipyridamole that is taken by mouth

This form may make your blood pressure drop when you stand up. This can make you dizzy and may lead tdangerous falls. More effective alternatives are available. The form of dipyridamole that is injected, however, can be used during a heart "stress test."

There are other drugs that provide better results in patients with atrial fibrillation (irregular heartbeat) or heart failure.

Avoid in some patients with atrial fibrillation or heart failure.

Digoxin at doses higher than 0.125 milligrams per day

In older patients with heart failure, higher doses appear toffer nadditional benefit and may increase risks of dangerous side effects. Older patients with kidney problems are at particular risk of side effects.

Avoid

Nifedipine, immediate release

This drug may lower blood pressure and could cause other heart problems.

Avoid

Spironolactone at doses higher than 25 milligrams daily

In people with heart failure, higher doses may boost risks of high potassium.

These medications may not significantly improve sleep and can cause many serious side effects, including confusion, falls, and bone fractures.

Avoid ongoing use of these drugs (over 90 days).

Ergot mesylates Isoxsuprine

These medications are not very effective.

Avoid

Drugs and treatments for conditions affecting the glands that produce and secrete hormones, such as androgens ("male hormones") and estrogen and progestins ("female hormones")

Androgens

Methyltestosterone

Testosterone

These drugs may worsen heart problems and cause other side effects. They shouldn't be prescribed for men with prostate cancer.

Avoid using in men with prostate cancer. In other men, prescribe only for moderate to severe declines in natural testosterone production.

Desiccated thyroid

Desiccated thyroid may not be appropriate for patients with a history of heart problems. Safer medications are available.

Avoid

Estrogens with or without progestins

These hormones may increase risks of breast cancer and cancer of the lining of the uterus. They don't appear to help protect women from heart disease or loss of cognitive (thinking) ability in later life. Estrogen cream inserted into the vagina does help vaginal dryness and is safe in women with breast cancer, especially if low doses are used.

Avoid pills and skin patches. Vaginal creams can be used at low doses to relieve pain during sex, and help prevent urinary tract infections, and related vaginal problems.

Growth hormone

Growth hormone has many side effects, including joint pain, swelling, enlargement of breast tissue in men, and carpal tunnel syndrome. It may also increase the chance of getting diabetes.

Avoid, except in patients who have had their pituitary gland removed for medical reasons.

Insulin, sliding scale

This way of dosing insulin is not very effective and can increase the chance of low blood sugar.

Avoid

Megestrol

This drug, prescribed to increase appetite, is not very effective, and may increase the chance of blood clots and, possibly, death.

Avoid

Sulfonylureas, long-duration

Chlorpropamide

Glyburide

Both medications can cause dangerous low blood sugar and other side effects in older adults. Safer medications are available.

Avoid

Medications for gastrointestinal problems

Metoclopramide

This medication may cause shakiness, sleepiness, and uncontrollable abnormal body movements. Frail older adults may be even more likely to get these effects.

Avoid, except for gastroparesis, a condition that reduces the ability of the stomach to empty its contents.

Mineral oil, taken by mouth

When swallowed, mineral oil may be accidentally inhaled and, as a result, can cause pneumonia. Safer medications are available.

Avoid

Trimethobenzamide

Not very effective for treating vomiting. This medication can cause side effects such as shakiness, sleepiness, and abnormal body movements.

Avoid

Pain Medications

Meperidine

This is not a very effective pain reliever and may seizures. Safer medications are available.